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Molly-Jayne Bangert, BSN, RN, CDE, working in the rural Southwestern United States, is passionate about increasing diabetes awareness and reducing risks associated with diabetes and pre-diabetes
In urban versus rural areas, what are the differences you see in the incidence of diabetes?
The incidence of diabetes and (maybe more critically) pre-diabetes in our rural communities appears to be more than the nationally reported averages. We have families with several generations living in the same community, and more and more of them are having diabetes in two and three “living” generations. Since families are often more closely connected in rural areas, it is important that we focus on family interventions, as they will make a huge difference immediately and in the long run.
What challenges does a diabetes professional face when managing someone with diabetes in a rural area of the United States?
The single largest challenge is the lack of resources that are committed to optimal diabetes outcomes, including nurses who are passionate about diabetes education, dietitians, physicians and mid-level providers. With only one fulltime certified diabetes educator for my six-county region, the 8,000-square-mile geographical distance is also a barrier to people getting access to the education that is offered. We’re working to take education to those who need it, but it is with considerable challenges.
You wear a pump yourself. What advantages do diabetes professionals with diabetes have over those who don’t have the condition?
The advantages of [having had type 1 diabetes for more than 27 years and also] wearing a pump are that I can tell my patients that I truly understand what I’m asking them to do, as I strive daily to practice what I preach. Whether it’s carb counting, checking BG levels or managing stress, my personal stories of successes and challenges often help them to understand they are not alone, and that it is a journey of improvement, not always perfection. I’ve been able to share what my choices have provided me and also cost me over time. What I share with them in “educational” information is often not very different from what other providers or educators will tell them.
What does it take to be a good diabetes educator today?
Other educators may define this differently, but for me, I believe that as a certified diabetes educator, I must have integrity, respect and commitment. Integrity in knowing that I give information that is accurate for people to base their personal decisions on. Respecting their choices and readiness to learn and where they are in their change process. Committed to working with and supporting the healthy choices they do make. My commitment is to make their educational experience personal and effective. I believe that life—with or without diabetes—isn’t about daily perfection. It is about consistency.
What is your impression of diabetes care today?
When provided as a team, it works! Many primary care givers don’t have or take enough time to provide even basic information about diabetes and other chronic diseases, nor do they stress the essential value and responsibility of self-management or what I call empowerment.
In the era of obesity and type 2 epidemics, how does diabetes education have to change?
Diabetes educators—and educators in general—very early on need to be candid about the consequences and risks of the extra weight. Helping people understand that when we talk about obesity, it is a reference to health risks and not a personal judgment. I am finding that more and more people are ready to make the therapeutic lifestyle changes when they fully comprehend what may likely happen (such as developing type 2 diabetes and its complications) if they don’t work to change the habits that led them to where they are.
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.